An Epidemic of Arm Injuries from Little League to Major League Baseball
Miami Marlins pitcher Jose Fernandez had a great rookie season last year and that might be an understatement.
The Cuban athlete was selected for the National League All-Star team, won the NL Rookie of the Year Award, and struck out almost 200 hitters, but this season hasn’t gone as planned for the 22 year-old.
Fernandez suffered an arm injury in early May that needed Tommy John surgery, and he won’t pitch again until next season.
Arizona Diamondbacks pitcher Patrick Corbin was a National League All-Star last year in his second season. He struck out almost 200 hitters and won 14 games, but the 25 year-old won’t pitch a single game this season because he needed Tommy John surgery in the offseason.
New York Mets pitcher Matt Harvey was also a National League All-Star last year in his second season. He also struck out almost 200 hitters, and the 25 year-old won’t pitch a game this year because, you guessed it, he needed Tommy John surgery in the offseason.
These three pitchers aren’t the only major leaguers to require the surgery. According to research from mlbreports.com, 28 MLB athletes have gone under the knife this year, 19 last year, and 36 in 2012.
Matt Harvey hopes somebody can figure out how to reduce the number of surgeries.
“It’s almost every other week you’re hearing about somebody going down with this injury,” Harvey said to reporters when speaking about his rehabilitation from Tommy John surgery in late July.
“The question is, why is this happening so frequently?”
The surgery has the name of former Major League Baseball pitcher Tommy John because he was the first to undergo the procedure.
The operation occurs when a ball player tears what’s called the ulnar collateral ligament located in the elbow. Surgeons take a tendon from another part of the body, like in the forearm, and recreate the ligament.
The rehabilitation process after Tommy John surgery typically takes between a year and 18 months.
Major League Baseball teams sometimes spend millions of dollars acquiring talented pitchers, and losing a hurler for a year or more can hurt the team both financially and in the team’s overall performance.
Many squads have started limiting the number of pitches and innings a pitcher can throw during the season, but even with teams putting restrictions on how much pitchers throw, the number of Tommy John surgeries is still high.
Some former Major League Baseball players think guys aren’t throwing enough.
“I think that when guys are brought in the league, they aren’t throwing a lot of innings, they aren’t expected to throw a lot of innings,” said former pitcher Dave Stewart, a three time World Series champion who played for 16 seasons. “There’s too much attention to weight lifting, not enough to throwing a baseball.”
He’s not alone. Former Oakland Athletics pitcher Rollie Fingers won an American League Cy Young award and was elected to the National Baseball Hall of Fame and Museum in 1992.
“I don’t remember starters being on the [disabled list] in the years I was on the A’s,” Fingers said. “I don’t know who came up with the 100 pitch rule, but I guarantee you he never threw 100 pitches.
“Guys need to start throwing more, the inning limit and all that stuff is crap.”
Doctors seem to disagree, and have said that throwing too much is a major factor for the arm injury.
Dr. Frank Jobe performed the first ever Tommy John surgery on the former pitcher, and before passing away earlier this year, he said it’s no secret what’s causing pitchers to get the surgery
“I think that's pretty well known about baseball players nowadays, the elbow has to have recovery time,” Jobe said.
Then there’s Dr. Anthony Scillia, a surgeon at the New Jersey Orthopaedic Institute. He specializes in elbow reconstruction and has done research in pitching mechanics and Tommy John surgery.
“I think it’s pretty clear that this is seen as an overuse injury to the ligament, so stretching and then eventually tearing,” Scillia said. “The ligament can’t heal itself, that’s why the surgery is required.”
Another factor for the rise in Tommy John surgery is the rising velocity of today’s pitchers. The harder a pitcher throws, the more stress is put on the arm, and eventually that can lead to a ligament tear.
Then there’s another factor contributing to the increase in these arm injuries.
While Major League ball clubs can control the innings and pitch counts of pitchers at the professional level, they aren’t able to monitor how much a player throws in youth leagues. Over the long period of time playing in Little League, tournaments with travel teams, high school ball, college ball, the minors, and eventually the majors, doctors have said that stress on the elbow ligament can wear down and tear.
“The kids now see baseball as a way to get a college scholarship, so now kids play year-round and have travel teams, and so I think throwing so much is definitely the reason for it,” said Dr. Joshua Dines, a sports medicine orthopedic surgeon at the Hospital for Special Surgery.
Research shows that big leaguers aren’t the only ones getting Tommy John surgery more often.
The American Sports Medicine Institute studied the number of baseball related elbow injuries that resulted in the surgery from 1994 to 2011. But rather than look at professional athletes, they focused on ballplayers in youth leagues and high school.
The study found that in 1994, zero percent of the surgeries at Andrews Sports Medicine dealt with reconstructing the elbow ligament, but there’s a sharp increase in the 2000’s, and the number rises to 32 percent in 2008.
Dr. Frank Cordasco, a sports medicine orthopedic surgeon at the Hospital for Special Surgery, said there’s no doubt that he and other sports specialists have seen more teens having the procedure.
“I think one of the major factors associated with this injury is associated to fatigue,” Cordasco said. “The fatigue can come from a single game, a season, or just year-round playing.”
Sports specialists are in agreement that overuse is the number one cause for arm injuries with young ball players, and their message for reducing Tommy John surgery is no surprise. They say teens need to rest their arms.
Doctor Anthony Scillia offers his advice for parents and teens who want to avoid Tommy John surgery.
“Stick to pitch counts, play for one team per year, and stop pitching for four months out of the year, that will really reduce your chance for injury,” Scillia said. “Just try to ensure they do not overuse their elbow at the young age.”
Sports fans have heard and probably used the expression ‘steroid era’ to describe the past two decades of Major League Baseball, but with the MLB cracking down on performance enhancing drugs, it looks like baseball has a new issue on its hands—the Tommy John era.